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Chinese Neurosurgical Journal

, 3:19

First Online: 04 July 2017Received: 09 February 2017Accepted: 10 May 2017


BackgroundDecompressive craniectomy DC has been the classical management for malignant middle cerebral artery infarctions mMCAI in clinical practice. However, the association between DC and mMCAI remains unclear. This review went to evaluate the efficacy of DC in treating mMCAI patients.

MethodsStudies were entirely searched since the foundation dates of multiple databases to June 2016. All major databases were involved, including Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, and other sources. the bias risk of studies involved were evaluated. Modified Rankin Scale was defined as Primary outcome, Odds Ratio and 95% confidence intervals was taken as measurements. T2 tau-squared test, I2 test, and chi-square tests were used for statistical heterogeneity evaluation for each meta-analysis result, followed by fixed-effect model. Mantel-haenszel method was used in the process of summary estimations. All of the meta-analysis was conducted by Review Manager 5.3.

Results and ConclusionOne thousand one hundred forty-five records of data were critically identified and collected through databases and 14 studies were finally involved. Result suggested that DC can ameliorate the suboptimal outcome of mMCAI patients.

KeywordsDecompressive craniectomy Malignant middle cerebral artery infarction Meta-analysis AbbreviationsCIConfidence interval

DCDecompressive craniectomy

DECIMALDecompressive craniectomy in malignant middle cerebral artery infarction

DESTINYDecompressive surgery for the treatment of malignant infarction of the middle cerebral artery

HAMLETHemicraniectomy in older patients with extensive middle-cerebral-artery stroke

HeADDFIRSTHemicraniectomy and durotomy upon deterioration from infarction-related swelling trial

mMCAIMalignant middle cerebral artery infarctions

mRSModified Rankin Scale

NIHSSNational Institute of Health stroke scale

OROdds ratio



RCTsRandomized controlled trials

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Autor: Long Xu - Te Lu - Xiaogang Tao - Dandan Wang - Weiming Liu - Jingsheng Li - Baiyun Liu


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